MEDICARE: ADA MUNIZ-LEE MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1225465545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADA MUNIZ-LEE MS

Provider Business Mailing Address
First Line	:	1 FOLKSTONE CT
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4298
Country	:	US
Telephone Number	:	732-422-9680
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 FOLKSTONE CT
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4298
Country	:	US
Telephone Number	:	732-422-9680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2013
Last Update Date	:	10/01/2013

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